Schwartz Rounds

Your name
Organisation
Where and when

Structure of talk
What is the problem?
What can help?
What are Schwartz Rounds?
What is the evidence?
Next steps

What is the problem?

A demanding healthcare environment
NHS funding constraints
Patient population older, more frail and complex
High turnover of staf
High levels of organisational change and
uncertainty
Short term relationships between staf and
patients
Pressure to reduce lengths of stay
Staf working very long shifts.

What is the problem? (continued)

Pressures on staff wellbeing
The 2015 NHS Staf Survey told us:
o37% of all staf reported feeling unwell due to work
related stress and pressure.
o63% of staf reported coming to work in the last 3
months despite feeling unable to perform their
duties
oOnly 52% felt involved in deciding on changes in
their team, department or work area.
o64% of staf reported that their most recent
experience of physical violence was at work.
o59% said they would recommend their organisation
as a place to work.
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What is the problem? (continued)

Staff experience is a driver of patient experience
If staf are unsupported they are more likely to:
Withdraw from their work for emotional protection
Feel more isolated and stressed
Have a lowered sense of personal efectiveness
Feel emotionally exhausted
Depersonalise care.
These responses are likely to have a negative onward impact on the safety and quality of
patient care (Maben et al, 2010; Raleigh et al. 2009).

All NHS organisations will understand the positive impact that

happy and engaged staff have on patient outcomes, including
mortality rates, and will be making this a key part of their
quality improvement strategy. Keogh, 2013
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What is the problem? (continued)

Dr Kieran Sweeney, GP, academic and
patient
The health professional does a job, and for
many people this job is pretty mundane.
Theyre doing the same kind of thing to the
same kind of people pretty well every day.
So for them that activity becomes
completely routine. And in some cases rather
dull.
For the individual patient its anything but
that. Every individual that comes through a
hospital is apprehensive. Its a strange place,
you lie in a strange bed, you have strange
sheets, you have odd tea in a plastic cup.
The whole thing is vibrantly different.
https://www.youtube.com/watch?v=--uMNY5
5nw4
Mesothelioma: A patients journey
Sweeney, Toy and Cornwell: BMJ 2009

What helps?
Interventions that aim to support staff in their
work.
Ideally these should be:
1.Compatible with a systems perspective
2.Described in enough practical detail to be replicated elsewhere
3.Flexible, so they can it be adapted to diferent environments
4.Sustained or spread beyond the place where it originated
5.Subject to an external process of assessment or evaluation.

Reference: Adapted from Greenhalgh et al 2004. Goodrich J, Cornwell J 2008 Seeing the Person in
the Patient Kings Fund.

Schwartz
Rounds
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Schwartz Rounds
Mentioned in the Francis Report as being
something that
can improve team building.
Mentioned in NHS England Business Plan (2014)
as evidence

based initiative to

improve

patient experience
Now running in over 130 healthcare
organisations across the

UK.

Organisations running Rounds by type

(March 2016)

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What is a Schwartz Round?

Schwartz Rounds are a confidential, multidisciplinary
forum designed for staf to come together once a
month to reflect on the emotional and social
experiences associated with their work.
ALL STAFF are invited (clinical and non-clinical),
recognising that each individual has something to
contribute
They follow a specified, evidence-based format
The focus is not on the clinical aspects of the patient,
but on staff experience
No answers or expertise are sought
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Format of a Round
Food is always provided at Rounds as it demonstrates that the
organisation values its staf and their time
Round lasts for 1 hour in total
The presenting panel share their experiences for 10-15 minutes
Trained facilitators then moderate a reflective discussion
The audience share their thoughts, ask questions, ofer similar
experiences
The discussion does not aim to problem-solve or find
solutions, but just reflect on the emotional experience of
delivering care. This can feel counter-cultural.

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Schwartz Round topics

Each Round has a topic. For example:
Trying to help in impossible circumstances
Conflict with patient; family; colleagues
Unrewarding patients
Rewarding patients and perils associated with them
Organisational events, e.g. poor CQC report or a major
complaint
Were human too personal and professional overlap
The patient Ill never forget.

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Who is involved?
Two facilitators (minimum time commitment 1day/month)
who will prepare the panel and facilitate the Rounds.
One clinical lead (minimum time commitment half
day/month) who will co-facilitate the Rounds.
Administrator (minimum time commitment 1day/month)
who will organise the Rounds and steering group meetings.
A steering group (time commitment half day/month) who
will meet once a month and attend the Rounds.
The board will need to fully support the initiative and the
internal resource required, including provision of venue and
catering.

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What is the evidence?

Two key studies (Lown & Manning, 2010, and Goodrich,
2011) have shown that staf who participated in Rounds
(especially those who attended regularly) reported:
Decreased feelings of stress and isolation
Feeling valued
Improved team-work, connectedness and communication
Greater appreciation for other disciplines / roles
More openness to giving and receiving support
Diminished hierarchies between senior and junior staf
Increased feelings of compassion towards patients
Increased attentiveness to social and emotional aspects
of patient care.

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Feedback from Rounds

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Feedback from Rounds

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Impact of Schwartz Rounds

(Continued)
What did participants say?
INSERT FROM CHOICE OF QUOTES BELOW

Schwartz Centre Rounds

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Next steps

Go to our website and download an information pack

Contact the Programme Manager to discuss further

estherflanagan@pointofcarefoundation.org.uk

Contact the administrator to arrange to observe a Round

info@pointofcarefoundation.org.uk

Identify a facilitator, clinical lead and administrator

Identify members of the Steering Group

Get board support to sign contract and pay for support from
The Point of Care Foundation

Attend training

Note: only organisations supported by The Point of Care Foundation

are authorised to run Schwartz Rounds.
Schwartz Centre Rounds

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Contact details
Esther Flanagan
Programme Manager
estherflanagan@pointofcarefoundation.or
g.uk
Bex Wickens
Programme Coordinator
rebeccawickens@pointofcarefoundation.o
rg.uk
Aisha Babb
Programme administrator
AishaBabb@pointofcarefoundation.org.uk

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